How is endometrial adhesion surgery performed?

There are many problems with a woman's endometrium, including endometrial adhesions. This problem can be mild or severe, and patients need to go to the hospital for a detailed examination. If the endometrial adhesions are severe, women will experience habitual miscarriage after pregnancy, and may even directly lead to infertility. For the problem of endometrial adhesions, the most important treatment method is surgery. The detailed steps of the surgery are as follows.

Endometrial adhesion surgery methods:

1. Empty the bladder, take the lithotomy position, disinfect the vulva and vagina, and lay a sterile surgical towel.

2. Bimanual examination to understand the size, position, texture, mobility, shape of the uterus and its relationship with surrounding organs, and whether there are any abnormalities in the appendages on both sides.

3. Place the speculum, expose the cervix, disinfect the vagina and cervix, clamp the anterior lip with a cervical clamp, and pull it outward to make the uterus horizontal.

4. Use a uterine probe to gently detect the depth and resistance along the direction of the uterus to identify the adhesion site. Mild adhesions can be broken up with a little force. For those who have difficulties, the operation should be performed under B-ultrasound, hysteroscopy or laparoscopy to detect perforation in time.

5. Use Kelly forceps (curved vascular forceps) to gradually separate, apply force evenly, and keep the depth and width moderate. If there are difficulties, the operation can be performed under direct vision of the hysteroscope, using micro scissors, sheaths or electric cutters.

6. After separation, insert the IUD as usual to prevent adhesion.

Postoperative care

The following treatments are done after endometrial adhesion separation:

1. Artificial cycle treatment for 2 to 3 months after surgery is beneficial to the proliferation and repair of the endometrium.

2. Performing HSG or hysteroscopy after IUD and artificial cycle treatment can prevent the occurrence of new adhesions.

3. If contraception is not needed, remove the IUD after 4 to 8 weeks and observe for 2 to 3 menstrual cycles before reexamination.

4. If postoperative review confirms that the separation of intrauterine adhesions is incomplete, adhesion separation surgery can be performed again after half a year.

Preoperative preparation

1. Check blood routine, platelets, leucorrhea routine, and measure body temperature. For those over 45 years old, blood pressure and pulse should be measured. Patients suspected of having heart disease should undergo an electrocardiogram.

2. Sexual intercourse is prohibited for 3 days before surgery.

3. Understand the menstrual cycle carefully.

4. Patients with IUDs should undergo fluoroscopy or B-ultrasound examination before surgery.

5. Establish an infusion channel and be ready for blood transfusion at any time.

6. For patients with inflammation who require surgery, antibiotics should be used starting before surgery and continuing until 3 to 5 days after surgery.